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Laparoscopic coloproctectomy with ileoanal pouch anastomosis for familial adenomatous polyposis (FAP)
Coloproctectomy is a challenging surgical procedure, whether open or laparoscopic, particularly when an ileoanal anastomosis with pouch is performed. The objective of this film is to provide some tricks to perform this surgical procedure laparoscopically.
The main trick is probably the preservation of the right and ileocolic vessels and of the right Drummond marginal vascular arcade that later allows for a division of the superior mesenteric vessels, if necessary to gain a length of 2 to 3cm in the pelvis.
The use of new sealing devices such as the Ligasure™ blunt tip facilitated the standardization of the procedure.
J Leroy, J Marescaux
Surgical intervention
7 years ago
2845 views
76 likes
0 comments
14:18
Laparoscopic coloproctectomy with ileoanal pouch anastomosis for familial adenomatous polyposis (FAP)
Coloproctectomy is a challenging surgical procedure, whether open or laparoscopic, particularly when an ileoanal anastomosis with pouch is performed. The objective of this film is to provide some tricks to perform this surgical procedure laparoscopically.
The main trick is probably the preservation of the right and ileocolic vessels and of the right Drummond marginal vascular arcade that later allows for a division of the superior mesenteric vessels, if necessary to gain a length of 2 to 3cm in the pelvis.
The use of new sealing devices such as the Ligasure™ blunt tip facilitated the standardization of the procedure.
Transumbilical single incision laparoscopic total colectomy and partial proctectomy with ileorectal anastomosis
This video demonstrates our transumbilical three-trocar technique for single incision total colectomy and partial proctectomy with intracorporeal side-to-end ileorectal anastomosis using standard laparoscopic instrumentation. The patient is a thin 19-year-old boy with a BMI of 19 presenting with familial adenomatous polyposis (FAP). The previous colonoscopy has shown 300 polyps in the colon and very few in the distal rectum.
Conventional trocars (5mm, 10mm, and 12mm) are used through a 3.5cm transumbilical incision. The ligation of the vessels is mostly carried out by the Ligasure-V vessel-sealing device using a medial-to-lateral approach. The specimen is extracted through the umbilical incision after removal of the 10mm and 12mm cannulas. The ileorectal anastomosis is carried out intracorporeally using a double stapling technique.
JR Ramos, R Mesquita Machado, EA Valory, AH Creiler
Surgical intervention
9 years ago
1416 views
13 likes
0 comments
11:14
Transumbilical single incision laparoscopic total colectomy and partial proctectomy with ileorectal anastomosis
This video demonstrates our transumbilical three-trocar technique for single incision total colectomy and partial proctectomy with intracorporeal side-to-end ileorectal anastomosis using standard laparoscopic instrumentation. The patient is a thin 19-year-old boy with a BMI of 19 presenting with familial adenomatous polyposis (FAP). The previous colonoscopy has shown 300 polyps in the colon and very few in the distal rectum.
Conventional trocars (5mm, 10mm, and 12mm) are used through a 3.5cm transumbilical incision. The ligation of the vessels is mostly carried out by the Ligasure-V vessel-sealing device using a medial-to-lateral approach. The specimen is extracted through the umbilical incision after removal of the 10mm and 12mm cannulas. The ileorectal anastomosis is carried out intracorporeally using a double stapling technique.
Laparoscopic total colectomy for T4N0M0 right colonic cancer and Lynch syndrome
The authors demonstrate their technique of laparoscopic total colectomy indicated for T3 tumors of the right transverse colon in a 40-year-old man with a family history of Lynch syndrome. Colonoscopy performed 3 years earlier ruled out the presence of polyps. Due to the tumor's invasiveness and the necessity to perform repeated endoscopic monitoring, it was decided to perform a total colectomy. The intervention is begun to the right and is completed to the left making sure to avoid any tumor manipulation. The different steps of the procedure are clearly outlined with images of outstanding quality. The vascular approach, especially to the right along the superior mesenteric axis, is beautifully exposed.
J Leroy, J Marescaux
Surgical intervention
6 years ago
6001 views
115 likes
0 comments
28:29
Laparoscopic total colectomy for T4N0M0 right colonic cancer and Lynch syndrome
The authors demonstrate their technique of laparoscopic total colectomy indicated for T3 tumors of the right transverse colon in a 40-year-old man with a family history of Lynch syndrome. Colonoscopy performed 3 years earlier ruled out the presence of polyps. Due to the tumor's invasiveness and the necessity to perform repeated endoscopic monitoring, it was decided to perform a total colectomy. The intervention is begun to the right and is completed to the left making sure to avoid any tumor manipulation. The different steps of the procedure are clearly outlined with images of outstanding quality. The vascular approach, especially to the right along the superior mesenteric axis, is beautifully exposed.